海绵窦肿瘤的诊断和显微手术切除

Diagnosis and Microsurgical Removal of Tumors Involving the Cavernous Sinus

报告13例海绵窦肿瘤,包括6例垂体腺瘤、5例脑膜瘤、1例神经纤维瘤和1例脊索瘤,主要表现为头痛、视力减退、突眼、眼球活动障碍和内分泌紊乱。CT和MRI对确定肿瘤是否侵入海绵窦内具有重要意义。13例肿瘤分别经海绵窦外侧壁、上壁和内壁切除,无手术死亡。颅神经损伤发生率为38.5％,与文献中报告的(22～61％)相仿。作者介绍了手术方法及防止术中出血和颅神经损伤的体会。

Thirteen cases of tumors involving the cavernous sinus, including 6 pituitary adenomas, 5 meningiomas, one neurofibroma and one chordoma, were reported. The clinical manifestations of these patients were headache, visual deterioration, exophthalmus, palsy of eye movements and endocrinic disturbances. CT and MR played an important role in verifying if the tumors involved the cavernous sinus. All 13 patients were operated on via the lateral, superior or medial wall of the sinus respectively without mortality. The cranial nerves were injured during operation in 5 patients (38.5%). The authors described the operative techniques and the experiences of prevention of hemorrhage and cranial nerves injury.